Since the humidity and heat decided to die down for a day, it has been feeling downright cool outside — 70° with a pleasant breeze. Things smell different — there’s a crispness that isn’t fall but isn’t the oppressive July heat, either.
Halfway through yet another rotation (pediatric dentistry), I’m beginning to realize that there is a point in my life when I’ll be done with dental school. At that point, I’ll have a world of options in front of me. Like a river delta opening into the ocean, my life will have 1000 directions where there once was one. Invigorating, right? Well, I suppose. More on that in a minute. Here’s something I wrote almost four years ago, on the private changelog for my software that powers tumbledry:
23 Jan 2008
Dental school begins in 7 months. If tumbledry is to survive four years of
dental school and beyond, I must now take steps to make it ultra robust
and easily maintainable.
I remember thinking at that time how long four years seemed. I mean, I was going to be hard at it for four years! (Not entirely true: I did a redesign this spring I’d never have thought possible in 2008). Despite that, I’m happy I took the steps I did, because I’m realizing that the “ultra robust” (ha!) code I worked on needs to work for MUCH longer than dental school. It’s all just beginning.
Now, about those 1000 choices. Happiness studies have produced interesting results: show a person 3 paintings and tell them they get 1 for free, no exchanges or substitutions. Now, show another person those same 3 paintings and tell them they get 1 for free and that they can exchange it for another in a week, and they’ll never be as happy as the first person. Living with limitations on our choices helps us find happiness. You lose the burden of imagining greener grass on the other side when you know you can’t go to the other side. Case in point: I LOVE where we live. The lack of air conditioning, old bathroom, ancient windows… I don’t mind them. I know, with only 1 car and me biking to school, we can’t move. Until school is over.
Then what? Suddenly, we can live wherever we want. How can you be happy in a job when you’re always imagining how you could change jobs? Same with a house. It’s a little scary. You have to put your own limitations on your choices, I guess. Bit of a challenge.
Ok, it’s set. I take my third set of boards (NBDE written, Part II) on October 10 and 11. By my count, that’s just over 2 months from now. I have a large box of “decks” — 1440 flashcards made by some very smart (rich) company and distributed by the Minnesota Dental Association. They have some errors in them — let’s hope I don’t memorize any of the errors.
I’ve been doing 50 of them per day, and hoo boy do they take a while to get through. It doesn’t take long to answer the question and flip the card (“yay, I got it” or “crrrap, I missed it”). It does, however, take a while to get through all the extra information on the back of the cards. In the meantime, I wish I could see more of my wife.
I can’t stress enough how important it is to write bad
songs. There’s a lot of people who don’t want to finish
songs because they don’t think they’re any good. Well
they’re not good enough. Write it! I want you to write
me the worst songs you could possible write me because
you won’t write bad songs. You’re thinking they’re bad so
you don’t have to finish it. That’s what I really think
it is. Well it’s all right. Well, how do you know? It’s
not done!
Yesterday at 5pm, our power went out. A fierce storm pushed a power pole over Franklin Avenue and onto a tree. The whole contraption was emitting smoke and sparks when I passed it on my bike. Not big arcs of movie sparks and smoke. Just lazy tendrils of smoke and the occasional ominous sparking sound. It reminded me a steam engine that had run out of steam.
Mykala and I didn’t realize the power had gone out until we returned home at 9pm. It turns out that the power was uninterrupted until repair work began; before that (when the whole contraption was draped over the street), electricity was still flowing just fine. Here’s the thing about losing power in the summer — it’s hot. Really, really hot. Humid. Still. Dark. Sticky. Mykala lit a candle, causing me to launch a 10 minute campaign convincing her to extinguish it. We then sat there in the dark for 5 minutes, letting our eyes adjust until we could see that the drapes were completely still, despite our attempts to catch a breeze. “Let’s go to bed,” Mykala said. It wasn’t even 10pm.
We opened the one window in our bedroom that wasn’t stuck shut or taken over by a air conditioner, and Mykala began reading by book light. We both started sweating. And sweating. And sweating. I went to bed clean, and had to take a shower this morning before I went into clinic. By the time lunch rolled around, I was starving. Had I even been able to bike home in time for lunch, I would’ve found the power still out.
Apparently, at about 2:15pm, after 21 hours of outage-ness, the power returned to our duplex. It took quite a while to get all the spoiled food out of the fridge, and to launder the really sweaty sheets. Tonight, I’m going up to bed to a dark, quiet, 70°F air-conditioned bedroom. I’m going to climb into clean sheets and sleep. Sleep uninterrupted by sweating, extremely loud birds, thunderstorms forcing the closure of the only open window, weird dreams about spoiling food, or any number of things. Just really nice sleep.
My company offers every employee a free Stair Master for
personal use, 24/7. It’s double wide and you can do an
“up” or “down” workout. The best part about it is that it
serves the added function of access to all six floors in
our building.
Home is a five minute bike ride from school. I’ve increased my efficiency in clinic, freeing up time after my morning appointment. These two facts mean I get to come home and see my wife for lunch. I love that a lot.
Though Mykala is away right now, I can sit here at home, on a warm summer afternoon, and enjoy the view onto our tree-lined patio.
It’s really nice. Maybe I can find a job (or open my own practice) that lets me do something similar.
I work shoulder-to-shoulder with people whose future occupation Minnesota is calling “Dental Therapist” — essentially what a nurse practitioner is to a physician. Unlike nurse practitioners, however, Minnesota’s Dental Therapists do not enjoy nationwide support. I hadn’t realized how little support the entire occupation has until recently. Take a look at the American Dental Association’s Comment on American Association of Public Health Dentistry Dental Therapist Curriculum Development:
We will continue to work with the AAPHD and all
interested stakeholders toward the goal we all share—a
healthier more productive nation. But in doing so, the
Association will not erode its unequivocal opposition to
non-dentists performing surgical/irreversible procedures,
or to other proposals that we believe run contrary to the
public good.
It is rather odd to be in school alongside someone who is being trained in “unequivocal opposition” to the ADA’s recommendation. The legislature’s idea (which has been, in turn, parroted by the leaders of our school) is that these dental therapists will be expected to serve areas of “need” where it is difficult for patients to easily access dental care. However, since there is absolutely no geographical restriction present (or as far as we can tell, planned) in their licenses that compels them to practice in a certain area, then they are free to practice wherever they’d like.
Thing is: dental therapy students are in a LOT less debt than dental students are. Extrapolation of this concept inevitably produces frustration. We don’t know if the dental therapy program will produce enough graduates to put any sort of pressure on new dentists in the market… but us dental students don’t exactly appreciate the possibility. Something similar has happened before: the UMN dental school admitted something like 50% more students than now in its classes in the 1980s. This created an excess population of dentists that took years to absorb into the market. We seem to be trending toward too many dentists (this time, minting quasi-dentists with an evolving set of legally accepted responsibilities and abilities) once again.
“My opinion is that human attention spans haven’t changed
much over time. We’ve always been a fairly short-sighted
species,” Bezos says, and laughs. “But while our
attention spans are staying roughly constant, our
problems are becoming much bigger, because of our past
successes as a species. Our tools, our technologies, now
require us to step it up, and have a longer attention
span.”
The things that have to be taken into account: the tendency of people to destroy things, geological stability, material science, engineering, speak to me very deeply. I love the idea of thinking about something, solving the problems around, making a manmade object last for an extremely long period of time.
During the credit boom of 2005 to 2007, profits and pay
reached unprecedented highs. It is now evident that the
bankers were being rewarded largely for taking on
unacknowledged risks: after the subprime market collapsed,
bank shareholders and taxpayers were left to pick up the
losses. From an economy-wide perspective, this experience
suggests that at least some of the profits that Wall
Street bankers claim to generate, and that they use to
justify their big pay packages, are illusory.
At the end of his piece, Cassidy links the stagnation of the middle class, which accelerated in the 1980s, to the simultaneous rise of giant Wall Street investment banking houses, derivatives traders, etc. I don’t think this causation hypothesis is entirely inaccurate, but I would instead emphasize Cassidy’s idea of a lack of societal contribution — as evidenced but he title, that’s the best take-away from the article.
So, what is the deal with the stagnation of the middle class? Krugman would attribute it to the loss of “strong unions, a high minimum wage, and … progressive tax system” that produced a broader distribution of wealth in the 40s and was dismantled in the 80s. I don’t disagree, but I think a force more powerful than government policies underlies the stagnation.
Certainly, the general declining trend of the US since the 1980s (punctuated by bubbles, growth, busts) is extraordinarily multifactorial, but I think Gladwell’s The Risk Pool points to an extremely important, always overlooked factor: our aging population.
This relation between the number of people who aren’t of
working age and the number of people who are is captured
in the dependency ratio.
…
Demographers estimate
that declines in dependency ratios are responsible for
about a third of the East Asian economic miracle of the
postwar era; this is a part of the world that, in the
course of twenty-five years, saw its dependency ratio
decline thirty-five per cent.
The more people you have working to support those who can’t, the more resources you have left over to grow. As our nation grows older and lives longer, our dependency ratio rises, and our working population must first support the growing ranks of the dependent before it can put resources towards growing our economy.
